Follicular Mucinosis (Alopecia Mucinosa)

Update on primary cicatricial alopecias

“…232 The head and neck are commonly involved, but disease can be widespread. A predilection for the eyebrows 207,211,226,233 and scalp 211,226 has been noted by some authors. Monomorphous or polymorphous disease is observed.…”

“…4,[207][208][209] Two distinct types of alopecia mucinosa are traditionally recognized: primary idiopathic and secondary lymphoma-associated disease. 210 Because of considerable epidemiologic and clinicopathologic overlap between these 2 categories, [211][212][213][214][215][216] and reports of development of lymphoma in a number of cases of primary disease, 209,217,218 this distinction may be artificial and potentially misleading practically. Primary and secondary alopecia mucinosa may instead represent aspects of a disease spectrum, with primary alopecia mucinosa alternately viewed as a premalignant condition 219 or an indolent form of follicular mycosis fungoides (MF) outright, with an excellent prognosis.…”

“…226,228 Lesional pruritus, 211,219 dysesthesia, [229][230][231] and anhidrosis 216 may be present. Expression of clear, mucinous fluid from follicular ostia may be elicited with application of pressure 211,226 or from sites subjected to biopsy. 232 The head and neck are commonly involved, but disease can be widespread.…”

Follicular Mucinosis

“…46,61,63,64 Besides mycosis fungoides and Sézary syndrome, Hodgkin disease has also been observed in association with FM in several patients. 8,44,[65][66][67] However, the association of Hodgkin disease with mycosis fungoides is well known, 68 and it might be that in at least some of these patients, cutaneous changes represented lesions of mycosis fungoides-associated FM. Indeed, most patients showed clinical presentations uncommon for idiopathic FM: One child described by Gibson et al 44 had a widespread skin eruption involving the upper and lower extremities as well as the face; the child described by Kim and Winkelmann 8 had multiple lesions on the arms and legs; the patient described by Stewart and Smoller 67 had lesions on both legs; and the one described by Ramon et al 65 had multiple lesions on the chest.…”

The Relationship of Alopecia Mucinosa to Malignant Lymphoma

“…He pointed out th a t follicular mucinosis m ay be found in certain cases of reticulosis and m alignant lymphoma of the skin. Kim and Winkelmann [7] recently could follow the histologic developm ent of a case from the inflam m atory phase of mucinosis follicularis into the full blown picture of mycosis fungoides. I am personally acquainted with four similar cases and have been able to investigate two of them in detail.…”